What is an Audiogram?

Understanding Audiogram

An audiogram is a visual record of hearing sensitivity. It plots the quietest sounds a person detects at selected frequencies, or pitches. Clinicians usually test tones from low-pitched sounds to high-pitched sounds and record each ear separately.

Related glossary terms: Hearing Threshold, Decibel, Conductive Hearing Loss.

The vertical axis shows loudness in decibels hearing level, abbreviated dB HL. Softer sounds appear nearer the top, while louder sounds appear lower on the chart. The horizontal axis shows frequency in hertz, abbreviated Hz, which describes pitch. A mark placed lower on the graph means the person needed a louder sound to detect that frequency.

How Audiogram Works, Is Measured, or Is Used?

A pure tone audiometry test creates the results shown on an audiogram. You listen through headphones or insert earphones while the clinician presents tones at different pitches. You respond whenever you hear a tone, even if it sounds very faint. The clinician reduces or increases the loudness to estimate the softest level detected reliably.

Testing may include air conduction and bone conduction. Air conduction checks the full hearing pathway through headphones or insert earphones. Bone conduction sends vibration through a small device placed behind the ear, which helps assess the inner ear without relying on the outer or middle ear. The difference between these results can help identify the type of hearing loss.

• Right and left ears are normally recorded with different symbols.
• Thresholds are commonly checked at speech-related frequencies and higher frequencies.
• Speech testing may be added to assess word recognition and functional listening.

Why Audiogram Matters?

An audiogram helps a clinician measure the degree and pattern of hearing loss rather than relying only on symptoms. Results may show normal sensitivity, mild loss, moderate loss, severe loss, or profound loss, depending on the thresholds and classification system used. The chart can also reveal whether both ears have similar results.

The pattern supports clinical decisions about further assessment and hearing care. A gap between air and bone conduction may suggest conductive hearing loss, while similar reduction across both methods may fit sensorineural hearing loss. Speech perception, medical history, ear examination, and communication needs must still be considered before interpreting the result.

When Audiogram Matters Most?

An audiogram becomes especially useful when you notice difficulty following conversation, asking people to repeat themselves, or increasing the volume of television. It also helps track hearing after repeated workplace noise, ear infections, head injury, or treatment that may affect hearing. A change between two tests may be more meaningful than one isolated result.

Clinicians use the findings when considering hearing aid fitting, communication strategies, or referral for medical assessment. Sudden hearing change, one-sided hearing loss, dizziness, ear pain, or discharge needs prompt clinical attention because an audiogram alone can't explain every cause. Test quality also matters, so the person must understand the instructions and respond consistently.